Liposuction helped shrink my agonising swollen leg: How lipo is relieving a chronic lymph problem affecting thousands
00:17 GMT, 21 August 2012
'My leg was so big, it was hard to bend it,' said Roisin Gallen
/08/21/article-2191175-14A0D12C000005DC-161_468x490.jpg” width=”468″ height=”490″ alt=”Six months after the operation, and for the first time in more than a decade, Roisin's legs are the same size, and she's back in size 12 clothes” class=”blkBorder” />
Six months after the operation, and for the first time in more than a decade, Roisin's legs are the same size, and she's back in size 12 clothes
As well as swelling, this trapped fluid puts patients at high risk of potentially life-threatening infection such as cellulitis, an infection of the tissues.
Something as innocuous as a graze can kick this off, as toxins can build up in the body.
Roisin’s GP initially mistook the swelling in her ankle a few weeks after her cancer treatment for simple fluid retention — an all-too-common occurrence.
Her condition was diagnosed five months later by a physiotherapist and she was given a compression garment to prevent fluid build-up as well as specialist lymphatic drainage massage to ease the fluid out.
This stopped when the physio went on maternity leave.
Like many patients, Roisin was to learn that treatment for the condition can often be patchy.
For the next two years she was on a waiting list for treatment, with her condition worsening.
She then contracted cellulitis, which fortunately responded to treatment but she was warned to go straight to hospital if it happened again.
/08/21/article-2191175-0B64458900000578-63_468x315.jpg” width=”468″ height=”315″ alt=”The surgery involved creating 14 holes in Roisin's leg using the specialised, extra-fine tubes necessary for lymphoedema liposuction” class=”blkBorder” />
The surgery involved creating 14 holes in Roisin's leg using the specialised, extra-fine tubes necessary for lymphoedema liposuction
‘People ask me whether it bothers me that I have to wear the garment — and it’s tight and hot in the summer,’ she says.
‘But I would honestly wear six of them at once if I had to rather than go back to how I was before my liposuction.’
Until now, the underlying causes of lymphoedema have been regarded as irreversible.
But now two remarkable pioneering surgical techniques that put a potential cure within sight have just started to become available in Britain.
In a healthy person, the lymphatic fluid drains into blood vessels after being filtered by the lymph nodes.
New imaging techniques are revolutionising lymph bypass surgery.
This involves pinpointing healthy lymphatic channels and re-routing them by stitching them into the blood vessels, bypassing blocked lymphatics.
But with some lymph vessels no more than 0.2mm wide, this is technically challenging microsurgery, explains Kelvin Ramsay, a plastic and reconstructive surgeon at the Royal Marsden Hospital, London.
First, dye is injected into the patient’s hand and it’s then taken up into the lymphatic system.
Surgeons turn out the lights and use a near-infrared camera, which lights up the microscopic lymphatic channels.
This shows clearly which channels are blocked so that only clear channels are grafted on to blood vessels.
There’s also lymph node ‘transfers’.
These aim to kick-start the lymphatic system by harvesting lymph nodes with their own blood supply from elsewhere in the patient’s body and plugging them into the armpits of breast cancer patients who have lymph nodes cleared or damaged by their cancer treatment.
As soon as the transferred lymph nodes are connected in the armpit, they start releasing substances that encourage the growth of new lymphatic vessels as well as the old pathway to open, says Anne Dancey, a plastic and reconstructive surgeon at the Queen Elizabeth Hospital in Birmingham who has already performed 25 lymph node transfers.
The hospital is now starting a clinical trial comparing lymph node transfer to standard treatment with specialist massage and compression garments.
As with the lymph bypass, before the transfer, dye is used to flag up the blockages.
‘My patients have been able to get rid of their compression garment and that is life-changing for them,’ says Ms Dancey.